Association between plasma complement factor H concentration and clinical outcomes in patients with sepsis
Open Access
- 19 January 2021
- journal article
- research article
- Published by Wiley in Acute Medicine & Surgery
- Vol. 8 (1)
- https://doi.org/10.1002/ams2.625
Abstract
Aim The complement system is important for defending against pathogens, however, excessive complement activation is associated with a poor prognosis and organ dysfunction in sepsis. Complement factor H (CFH) acts to prevent excessive complement activation and damage to the self through the regulation of the complement alternative pathway. We investigated the association between plasma CFH levels on admission to the intensive care unit (ICU) and 90‐day mortality, severity scores, and organ dysfunction in patients with sepsis. Methods We assessed the relationship between the plasma CFH on admission to the ICU and 90‐day mortality, severity scores such as the Acute Physiology and Chronic Health Evaluation II score, Sequential Organ Failure Assessment score, and Simplified Acute Physiology Score 2, and organ dysfunction. Results This analysis included 62 patients. The plasma CFH levels were significantly lower in 90‐day non‐survivors than in survivors (70.0 μg/mL [interquartile range, 51.2–97.6] versus 104.8 μg/mL [interquartile range, 66.8–124.2]; P = 0.006) . The plasma CFH levels were associated with 90‐day mortality (odds ratio 0.977; 95% confidence interval, 0.957–0.994; P = 0.01). The plasma CFH levels were negatively correlated with severity scores. The Sequential Organ Failure Assessment scores for the coagulation and neurological components were negatively correlated with the CFH concentration. Conclusion Lower plasma levels of CFH were associated with increased severity and mortality in patients with sepsis on admission to the ICU and were correlated with central nervous system dysfunction and coagulopathy.Keywords
This publication has 29 references indexed in Scilit:
- Thrombosis as an intravascular effector of innate immunityNature Reviews Immunology, 2012
- Sepsis-associated encephalopathyNature Reviews Neurology, 2012
- The Role of Complement System in Septic ShockJournal of Immunology Research, 2012
- Interactions between coagulation and complement—their role in inflammationSeminars in Immunopathology, 2011
- Complement: a key system for immune surveillance and homeostasisNature Immunology, 2010
- Atypical Hemolytic Uremic Syndrome: Update on the Complement System and What Is NewNephron Clinical Practice, 2010
- Sepsis-associated encephalopathy and its differential diagnosisCritical Care Medicine, 2009
- Inhibition of complement C5a prevents breakdown of the blood-brain barrier and pituitary dysfunction in experimental sepsisCritical Care, 2009
- The role of the complement cascade in endotoxin-induced septic encephalopathyLaboratory Investigation, 2007
- Complement anaphylatoxin receptors on neurons: new tricks for old receptors?Trends in Neurosciences, 1999